Screening for familial hypercholesterolaemia by measurement of apolipoproteins in capillary blood

Article Abstract:

Heterozygous familial hypercholesteremia is an inherited condition that causes abnormally high levels of cholesterol in the blood. It is one of the most common inherited metabolic disorders, and is estimated to occur in 1 of every 500 people. People who have this condition have an increased risk of developing atherosclerosis (hardening of the arteries) and heart disease. In some cases, atherosclerosis begins during childhood. Several studies have attempted to identify children at risk for familial hypercholesteremia. These studies have shown that screening based solely on the family medical history is successful in identifying only half the children who have this condition. Therefore, a blood screening program was established to screen children at risk for familial hypercholesteremia. Questionnaires regarding family history of heart disease were completed by 2,657 couples who had a child enrolled in the first grade of the Copenhagen School System in Denmark. Blood samples from 2,085 children were tested to determine the levels of apolipoproteins A-1 and B in the blood. Fifty-four of the children had very high levels. When the blood tests were repeated for this group, 17 of the children were again found to have very high blood levels of apolipoproteins A-1 and B. Hypercholesteremia was diagnosed in 12 of the children and in 10 of their families. Further testing performed in the families with hypercholesterolemia revealed that 29 relatives also had the disease. Only 5 of the 12 school children who were diagnosed as having hypercholesteremia had a family history of heart disease. These findings demonstrate that blood testing for apolipoproteins A-1 and B is a useful method of screening for familial hypercholesteremia, and that it provides more accurate results than those obtained from a family history. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Apolipoproteins, Blood, Lipoproteins, Blood lipoproteins, Hypercholesterolemia in children, Pediatric hypercholesterolemia

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Preschool vision screening

Article Abstract:

Although children should be tested for vision defects at the preschool age, it is unclear whether currently used vision screening programs are effective. Three different methods of preschool vision screening were assessed in 7,000 children. The subjects consisted of a younger group of infants, aged five months, and an older group of toddlers, aged 30 months. The children were assessed for new visual and ocular defects for a period of 18 months by ophthalmologists and opticians. The three screening methods included: (1) screening by an orthoptist based in the community at 35 months; (2) conventional health visitor surveillance at 30 months; and (3) a program of primary care screening for squint at 30 to 36 months. The effectiveness of the screening methods was determined by sensitivity and by incidence of treated visual disorders. Screening by a community-based orthoptist proved to be the superior methods. Thirteen of 1,000 children seen by an orthoptist were treated for straight eyed visual acuity loss, whereas none of 2,500 children screened by other programs were treated for this visual problem. All three screening methods produced poor results in the younger group of children; only one out of eight treatable visual conditions was detected among 3,500 infants screened. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Testing, Preschool children, Vision disorders in children, Childhood vision disorders

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